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Author Archives: JCDA Oasis

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Managing the patient with diabetes: Important considerations

This summary is based on information found in Diabetes Mellitus and Oral Health: An Interprofessional Approach, First Edition (Wiley Publishing, 2014)   Dental management of patients with diabetes can be challenging. Working closely with the physician and understanding the patient’s daily diabetes management regimen leads to developing appropriate pathways of care and minimizes risk for in-office emergencies. Results of periodontal therapy There is much less research examining the outcomes of periodontal therapy in periodontitis patients with diabetes compared to those without diabetes. The patient with undiagnosed diabetes Dentists and dental hygienists may be the first to recognize signs and symptoms, such as advanced periodontal diseases ...

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Is the anatomy of the root canal system a challenge to effective disinfection?

This summary is based on information found in Disinfection of Root Canal Systems: The Treatment of Apical Periodontitis (Wiley Publishing, 2014)   Six biological factors that lead to asymptomatic radiolucencies persisting after root canal treatment: Intraradicular infection persisting in the complex apical root canal system; Extraradicular infection, generally in the form of apical actinomycosis; Extruded root canal filling or other exogenous materials that cause a foreign body reaction; Accumulation of endogenous cholesterol crystals that irritate apical tissues; and True cystic lesions, and (vi) scar tissue (1). The internal anatomy can be notoriously complex, especially in molars, and includes extra canals, recesses, fins, isthmuses, and accessory canals that provide space for the biofilms ...

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What are some of the implant complications associated with systemic disorders and medications?

This summary is based on information found in Dental Implant Complications: Etiology, Prevention, and Treatment, 2 (Wiley Publishing, 2015) Key messages Patient selection is the critical factor for implant success and survival in any medically complex situation. When medical conditions are managed wisely, most patients have improved overall health with fixed replacements as opposed to removable appliances. Exceptional care must be taken so that any implants placed will be successful and safe for the clinician and the patient. It is essential to routinely review the literature and expect that protocols for patients with systemic diseases or taking medications will be regularly updated as our knowledge of dental implants advances.   Although ...

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Implant Complications: What is the Scope of the Problem?

This summary is based on information found in Dental Implant Complications: Etiology, Prevention, and Treatment, 2nd Edition (Wiley Publishing, 2015) The introduction of endosseous dental implants as an option for restoring partially and fully edentulous patients has revolutionized dental treatment. High survival rates reported for single and multiple missing tooth replacements have validated the use of implant-supported restorations as a predictable method for oral rehabilitation (1–9). Problems with implant complications have grown in number and complexity and that is reflected in the increased number of articles, journals, and continuing education conferences that have recently been devoted to the topic of implant complications (12–31). Reasons for the increased numbers of implant complications The ...

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What is the role of diet in the prevention of dental diseases?

This summary is based on information found in Comprehensive Preventive Dentistry (Wiley Publishing, 2013) Dental diseases in which diet plays an etiological role include enamel developmental defects, dental caries, tooth wear, and periodontal disease. The main cause of tooth loss is dental caries, and in adults the main cause of tooth loss is periodontal disease. There is strong evidence from epidemiological studies for an association between the amount and frequency of free sugars intake and dental caries. Studies of human populations show that diets that are rich in complex carbohydrates from starchy staple foods and diets that are high in fresh fruit are associated with low levels of dental caries. ...

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Evidence-Based Dentistry in a Nutshell

This summary is based on information found in Comprehensive Preventive Dentistry (Wiley Publishing, 2013) “Evidence-based health care takes place when decisions that affect the care of patients are taken with due weight accorded to all valid, relevant information” (Hicks 2011). To understand the concepts of evidence-based dentistry, it is important to understand the basis of epidemiology, the nature of a given research question, and the best study designs that would provide the evidence to such a question. Epidemiology The study of the frequency, distribution, and determinants of health conditions or events (including disease) in human populations and the application of such study to control diseases and other health problems (U.S. ...

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Value-Based Dentistry

Dr. Sree Koka, Prosthodontist in San Diego California, comes back to speak with Dr. John O’Keefe about his recently published article about value-based dentistry. Read the article here: Value-based dentistry: Putting the patient first Highlights When treating patients, it is advantageous to understand the concept of value-based dentistry. Practitioners should know what their patients perceive as value (preferences, beliefs, what they are looking for) as well as their perceptions about the cost of treatment which is not just financial, but biological, time and inconvenience costs. Value-based dentistry helps dentists to deliver individualized treatment options to patients that align with their values ...

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The Etiology of Dental Phobia

This summary is based on information found in Cognitive Behaviour Therapy for Dental Phobia and Anxiety (Wiley Publishing, 2013) Psychological and Interpersonal Aspects of Dental Treatment Taking different aspects of dental treatment into consideration, there is reason to believe that dental treatment triggers instinctive survival mechanisms. The threatening body position and potential obstruction of free air space during treatment may be perceived as threats by patients. Another essential feature of dental treatment is the intimacy of the oral area which may trigger a feeling of unpleasantness or stress and a defence reaction. Pain Dental tissues are highly innervated with pain receptors and almost any dental ...

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